WASHINGTON, D.C. – Uninsured Ohioans, like Americans
everywhere, stepped up their pace of enrollment in Affordable Care Act health
insurance plans during January, with nearly 3.3 million people nationwide now
signed up for a plan, new figures from the Obama administration show.

The administration painted the uptick as good news, and stressed
that a growing share of people signing up for coverage, or 25 percent nationwide, are young adults between the
ages of 18 and 34. Young, healthy enrollees are important because they do not use as much heath care as older Americans, offsetting
the older Americans' costs.

But state-specific data suggest that Ohio is behind the
curve and its health insurers may not see such a young-enrollee advantage. If
the trend holds, and it may not, it could affect heath costs and future
premiums.

Detailed data tables released Wednesday afternoon by the U.S.
Department of Health and Human Services, or HHS, show that the ages of Ohioans
signing up for private health coverage under the health insurance law, known
widely as Obamacare, skew higher than the national averages.

For example, 21 percent of Ohio's roughly 60,000 enrollees in
individual health plans under the Affordable Care Act, or ACA, so far are
between ages 18 and 34. That's four percentage points lower than enrollment for that age group nationally. But at the other end of the age spectrum, Ohio has had a
larger share of adults ages 55 to 64 signing up than
the national average.

Of everyone enrolled, those ages 55 to 64 represented 31 percent of the total pool nationally as of Jan. 31. In Ohio, that age group accounted for 38 percent of all enrollees statewide.

Only Maine, West Virginia and Wisconsin had higher shares of
enrollees in this age group.

Heath care authorities have said since the Affordable Care Act, or ACA, was passed in 2010 that for it to succeed in giving most Americans
health insurance while keeping premiums affordable, a large share of young,
healthy adults would have to enroll. Insurers write and sell their policies for specific states and price their policies based on age, smoking status and expectations of medical trends. Although they may charge higher premiums for older clients, the ACA restricts the level of variation.

HHS Secretary Kathleen Sebelius said on a
conference call this afternoon that nationally, young adults have clearly
increased their level of participation, and she called the overall enrollment
trends "encouraging news."

"Fifty-three percent more Americans are signed up today than
were signed up by the end of December," Sebelius said. "In human terms, this
means 1.16 million additional Americans will have quality, affordable health coverage
that's there when they need it."

Individuals still have until the end of March to get
coverage that begins in April, the start of the ACA's mandate for individuals
to get insurance or face penalties. Eighty-two percent of those who have signed
up so far will get tax subsidies based on their incomes, according to the HHS
figures.

Most employers will be required eventually to provide health
coverage for their workers. But the Obama administration has repeatedly pushed
back the date of employer mandates and penalties. Extensive problems with the HHS computer network for enrollment also resulted in numerous delays for uninsured individuals who wanted to sign up for coverage.

Even with Wednesday's release of data, HHS did not say how many of the individuals have actually paid their share of premiums so their coverage can begin.

A number of factors could account for Ohio's larger share of
older enrollees in the individual market, including the state government's refusal
to actively promote the ACA and the relative success or challenges that
nonprofit groups have had in encouraging uninsured Ohioans to sign up.

Federal officials did not directly address whether this age
difference in Ohio and the other states presents a problem. Nancy Delew, the
acting deputy assistant secretary for planning and evaluation, said on the call
with Sebelius that the age difference could be a reflection of these states' underlying
demographics.

The demographic difference in Ohio, however, is negligible
when compared with the national figures, U.S. Census Bureau data show.
According to the 2010 census, the national share of Americans ages 55 to 64 was
11.9 percent, compared with 12.6 percent in Ohio.

Julie Bataille, the communications director for the Centers
for Medicare and Medicaid Services, an HHS division, said in answer to the
question, "I would just remind you that every individual who is enrolled in a
health plan is a success story, and that those Americans now have access to
quality, affordable health coverage that they didn't before."

The HHS data contained some bright spots for Ohio. One is
that a majority of Ohioans signing up for coverage have chosen plans at the
silver, gold or platinum levels, color-coded to reflect their relatively
generous levels of coverage. The higher the level, the less a patient will have
to spent in out-of-pocket medical expenses.

Critics of the ACA predicted that large numbers would sign
up for lower-tier bronze coverage, which would stick them with out-pf-pocket
costs exceeding $6,000. But 58 percent of the Ohioans enrolled in silver plans,
18 percent in gold and 3 percent in platinum.

By contrast, 21 percent enrolled in bronze plans, and only 1
percent signed up for catastrophic coverage, a cheap, bare-bones category
available only to people under age 30 except for special circumstances.

Eighty-three percent of the Ohioans qualified for financial
subsidies, nearly matching the 82 percent national average. But there appeared
to be a correlation between subsidies and the level of coverage Ohioans
selected.

For example, 63 percent of those choosing silver plans got
at least some subsidy to help they pay, compared with only 21 percent of
bronze-level enrollees who qualified for subsidies. Tax subsidies are based of family income, phasing out after 400 percent of the federal poverty level, or about $92,400 for a family of four.

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